何时在腔道胃肠道疾病中使用益生菌?
When to use probiotics in luminal gastrointestinal disorders?
机构信息
Department of Internal Medicine-Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indiana, USA.
出版信息
Curr Opin Clin Nutr Metab Care. 2020 Sep;23(5):336-343. doi: 10.1097/MCO.0000000000000674.
PURPOSE OF REVIEW
With the growing popularity and commercialization of probiotics, it is important to understand the implications of existing randomized controlled trials and their applicability in the clinical setting to treat luminal gastrointestinal diseases.
RECENT FINDINGS
Probiotics may be useful in the prevention of antibiotic-associated diarrhea, prevention of Clostridioides difficile infection and eradication of Helicobacter pylori. Some evidence supports the use of probiotics in the treatment of ulcerative colitis, prevention and treatment of pouchitis and irritable bowel syndrome. Caution has to be exercised in immunocompromised and critically ill individuals. New society guidelines do not encourage probiotic use in gastrointestinal disorders with the exception of premature infants to prevent necrotizing enterocolitis.
SUMMARY
Despite burgeoning body of literature and wide acceptance by the public, a thorough understanding of efficacy and safety of probiotics is lacking. Uniform dosage, standardized clinical end points, personalization based on host microbial profile and longer duration of follow-up on the research front may help in the future in appropriate positioning of probiotics in health and disease.
目的综述
随着益生菌日益普及和商业化,了解现有的随机对照试验及其在临床治疗腔道胃肠道疾病中的适用性非常重要。
最近的发现
益生菌可用于预防抗生素相关性腹泻、预防艰难梭菌感染和根除幽门螺杆菌。有一些证据支持益生菌在溃疡性结肠炎的治疗、预防和 pouchitis 以及肠易激综合征的治疗中的应用。在免疫功能低下和重症患者中应谨慎使用。新的学会指南不鼓励在除早产儿预防坏死性小肠结肠炎以外的胃肠道疾病中使用益生菌。
总结
尽管文献大量涌现,公众广泛接受,但益生菌的疗效和安全性仍缺乏深入了解。在研究前沿,统一剂量、标准化临床终点、基于宿主微生物特征的个体化以及更长时间的随访,可能有助于将来在健康和疾病中正确定位益生菌。